A Model for Access to Gynecological Screening Examinations for Women with Physical Disabilities

Objectives:  Women with physical disabilities are less likely to receive cancer screening examinations and are at increased risk to undergo hysterectomy at a younger age as compared to their able-bodied peers.  Despite 20 years since the passage of the Americans with Disability Act, numerous barriers exist for women with disabilities in accessing preventive screening exams.  Independence Care System developed a model program to increase access to gynecological screening examinations. 

Methods:  This pilot project recruited women over the age of 21 with a physical disability who never had a gynecological examination or reported an adverse experience. One facility   agreed to participate in the project and received disability awareness and sensitivity training to all staff.   A nurse educator with expertise in disability accompanied each woman during her appointment providing support with navigating the facility and continuing through the actual gynecological procedure.     

Results:  The project commenced in April of 2012 and to date, 88 women have been screened.    The average length of time since their previous gynecological examination was 3.4 years.   Thirty percent were diagnosed with morbid obesity and over 80 % used some type of mobility aid. 

Conclusions:  The ICS model promoted compliance through the presence of a nurse educator at facilities trained in disability awareness. This program has been replicated at additional sites that include mammography screenings.  Our goal is to continue advocating this model to eventually include primary care so women with disabilities can obtain their healthcare needs at one site staffed by professionals specifically educated in serving this population.